IN the light of the current back and forth between junior and senior doctors, I would like to offer my opinion and in the process put some perspective to the debate.
I work in Hospital Tengku Ampuan Rahimah, Klang which is arguably one of the busier hospitals in the country as we have graced the pages of this august publication from time to time and yet, inspite of being overworked and understaffed, I have yet to see my junior doctors, whether house officers or medical officers, complain. If they did, I have not seen it in the form of letters to the editor or letters to the higher authorities.
Since there is now much negativity, the public might think that we do nothing but complain and fire letters to the editors of newspapers. Therefore, to correct this perception I have decided to write in praise of my junior doctors.
They carry out their work above and beyond their call of duty, silently and not expecting much in the form of praise or anything for that matter. They know they are paid the same as their colleagues in other hospitals, even though their workload is three or four times more. Yet, they show up for work every day and there is almost no mumbling, murmuring or grumbling.
My house officers are one of the few in the country who still have the pleasure of experiencing a ratio of one doctor: 30 or 40 patients.
Due to the shift system and the lack of available house officers we can only post one house officer per ward and two per ward on better days. Because of this shortage, sometimes they even have to do night shifts back to back.
The number of patients in one of our wards number about 70 and this does not include the scores that are lodging in the emergency department and in other departments which we also have to see and take care of.
Imagine having to clerk and examine all the new cases (our department averages between 40 and 60 new admissions a day) when we don’t take into account the dengue patients, do blood investigations for the patients, get their scans, go on rounds with the specialist, review all the patients’ blood investigations, resuscitate patients and set lines for this number of people.
Not all of them, at any given time, but a sizeable number will need any of the listed above. On top of that they have to do the discharge summaries and write referral letters to the various sub-specialty hospitals and health clinics.
What time is left for learning? What time is left for reading up? What time is left to follow the specialists on their rounds? What time is left for clinical and theoretical teaching? What energy have they left even if they have the time?
Doctors are not gods; they are still humans who go hungry, cry when hurt and bleed red if cut.
These are rough diamonds, not the finished product, so there are bound to be mistakes and inefficiencies, and picking up the slack will be the medical officers of Hospital Tengku Ampuan Rahimah, who even though have gone through housemanship and done their fair share, but seeing the insurmountable tasks of the house offficers, chip in and do the house officers’ work stated above. This is on top of their own duties.
These may include presenting to the specialists, running the clinics, doing procedures, liaising with the family members in arranging for further chronic care for patients with permanent disabilities and assisting the specialists in doing family conferences to discuss with family members of patients who have poor prognosis.
What do they get in return? No extra pay. No extra time off. No priority when applying to do their Masters.
All they have is the gratitude of the family members (which is sometimes non-existent) and the joy of seeing their patients do better. That is all.
My plea to all the other junior doctors is to look at your good fortune and stop complaining. If you are unhappy with your current workplace, please apply for a transfer to Klang. We will always welcome you.
To the higher authorities please send us help. No one can take such a heavy burden forever and one day my junior doctors will burn out.
What is a general without the infantry and cavalry? I salute my house officers and medical officers.
DR TAN GUO JENG
(Klang Hospital Specialist)
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